HX64074315 
RA427  L62  Prolonging  life  as  a 


RECAP 


PROLONGING  LIFE 
AS  A  FUNCTION  OF 
LIFE   INSURANCE 


mtljfCttpflmsfork 
College  of  3pf)j>55tctang  anb  burgeons 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/prolonginglifeasOOIife 


PROLONGING  LIFE 
AS  A  FUNCTION  OF 
LIFE  INSURANCE 

Five  Years'  Experience  of  the 
Life  Extension  Institute 


NEW  YORK 

25   WEST  FORTY-FIFTH   STREET 

1919 


u  62- 
Life  Extension  Institute,  Inc. 

Telephone  Bryant  1997 

25  West  45TH  Street,  New  York  City 

Chicago  Office  5  North  Wabash  Avenue 


OFFICERS  AND  DIRECTORS 

Hon.  William  H.  Taft,  Chairman  of  the  Board 

Prof.  Irving  Fisher,  Chairman  Hygiene  Reference  Board 
Professor  of  Political  Economy,  Yale  University 

Maj.-Gen.  William  C.  Gorgas,  Consultant 

Eugene  Lyman  Fisk,  M.D.,  Medical  Director 

Harold  A.  Ley,  President  James  D.  Lennehan,  Secretary 

Henry  H.  Bowman 
President  Springfield  National  Bank,  Springfield,  Mass. 

Robert  W.  deForest 
Vice-President  American  Red  Cross 

Arthur  W.  Eaton 
President  Eaton,  Crane  &  Pike  Company 

Edward  L.  Pierce 
President  Solvay  Process  Company,  Syracuse,  N.  Y. 

Charles  H.  Sabin 
President  Guaranty  Trust  Company  of  New  York 


PROLONGING  LIFE  AS  A  FUNCTION  OF 
LIFE  INSURANCE 

FOREWORD 

|UR  five  years'  experience  in  this  new  field  of 
social  medicine  has  been  so  interesting  and 
opens  up  such  tremendous  opportunities  for  service 
that  we  are  impelled  to  lay  the  facts  before  the  in- 
surance companies,  hoping  thereby  to  interest 
them  in  doing  something  along  this  line  of  con- 
structive effort. 

We  see  an  opportunity  not  only  for  important 
financial  returns,  materially  lowering  the  cost  of 
insurance,  but  concomitantly  what  we  consider 
more  important,  opportunities  for  making  valuable 
contributions  to  the  health  of  the  policyholders 
and  to  the  vitality  of  the  nation. 

It  is  axiomatic,  of  course,  that  it  is  impossible  to 
improve  the  health  of  policyholders  and  not  effect 
a  money  saving  represented  by  mortality  gains. 

We  believe  that  as  you  read  this  message  you 
will  be  impressed  by  the  reasonableness  of  our  con- 
tention that  the  periodic  physical  examination  of 
policyholders,  together  with  education  in  right  liv- 
ing based  upon  the  findings  in  these  examinations, 
would  be  a  common  sense  conservative  business 
measure    and    as   justifiable    as    the    preventive 

[7] 


methods  used  by  fire,  boiler,  and  liability  insurance 
companies  for  the  purpose  of  lowering  the  liability 
in  these  branches  of  insurance. 

In  due  course  it  will  doubtless  be  possible  to 
give  some  comprehensive  actuarial  expression  to 
this  saving.  At  present  all  we  offer  is  an  analysis  of 
the  conditions  found  and  of  the  opportunities  that 
exist  for  life  saving.  Individual  instances  are  ex- 
hibited showing  in  what  way  such  opportunities 
have  been  utilized  in  actual  life  saving.  It  is  thus 
possible  to  bring  sound  business  judgment  to  bear 
upon  the  possibilities  of  the  work. 

The  Institute  is  no  longer  a  paper  plan  or  theory. 
It  is  a  very  lively  and  important  business  and 
scientific  entity.  It  merits  investigation.  The  Insti- 
tute has  become  a  national  institution,  is  estab- 
lished on  a  sound  financial  basis  and  has  examined 
and  influenced  more  than  a  hundred  thousand 
lives.  Nevertheless  we  feel  that  it  has  only  just  be- 
gun to  do  the  work  for  which  it  was  organized. 
Now  that  peace  has  come,  the  progressive  minds  in 
this  country  are  turning  to  reconstruction  prob- 
lems and  to  the  best  utilization  of  the  suggestive 
lessons  derived  from  the  war.  There  is  no  more  im- 
portant duty  than  to  act  for  the  correction  of  our 
physical  deficiencies  as  revealed  by  the  war. 

The  time  is,  therefore,  opportune  for  insurance 
companies  to  consider  these  questions.  Work  of 
immense  importance  can  be  done  by  the  insurance 
companies   during   this   plastic  period  when   the 

[8] 


world  is  struggling  to  higher  planes  of  living.  We 

offer  our  experience  in  the  hope  that  it  will  have, 

at  least,  a  suggestive  value  in  broadening  the  scope 

of   insurance    benefits    and    insurance    influence 

among  the  people. 

Harold  A.  Ley 

President 

March,  igig 


09  ] 


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THE  BIRTH  AND  GROWTH 

OF  THE   LIFE  EXTENSION 

INSTITUTE 

THE  Boston  Transcript  relates  how  a  group  of 
elderly  ladies  were  discussing  the  circum- 
stances of  their  birth.  One  lady  remarked  that  she 
weighed  only  three  pounds  at  birth.  This  excited 
considerable  astonishment.  Another  member  of  the 
group  inquired  solicitously:  "And  did  you  live?" 
"Yes,"  was  the  answer,  "and  they  say  that  I  did 
well." 

It  is  now  five  years  since  the  Life  Extension  In- 
stitute was  born.  Notwithstanding  the  important 
scientific  and  financial  backing  that  it  had,  many 
good  friends  thought  it  was  a  "three-pound  baby" 
and  in  fact  a  premature  birth  about  twenty  years 
ahead  of  the  times.  To  such  who  ask  "did  it  live?" 
we  answer  "yes,"  and,  like  the  lady  in  the  story, 
"they  say  we  have  done  well." 

En] 


After  all,  the  proof  of  vitality  and  usefulness  is 
actually  to  live  and  to  accomplish  something. 

The  Institute  was  not  designed  as  a  great  money- 
making  institution;  its  purpose  was  to  become  self- 
supporting  while  carrying  far  and  wide  a  propa- 
ganda for  higher  health  ideals,  for  healthier  and 
more  efficient  living,  for  disease  prevention,  for 
longer  life  and  greater  capacity  for  living  well. 
These  objects  it  has  accomplished. 

It  is  well  known  to  the  life  insurance  world  that 
the  Institute  aimed  at  the  outset  to  reach  the  peo- 
ple through  the  life  insurance  companies,  organiza- 
tions mutually  interested  with  their  policyholders 
in  prolonging  human  life.  Several  companies  had 
the  courage  to  make  the  trial  and  important  work 
has  been  done  in  this  field.  The  privilege  of  periodic 
health  examination  through  the  Institute  has  been 
extended  to  more  than  600,000  insurance  policy- 
holders. In  addition,  a  number  of  companies  have 
been  moved  to  accept  the  principle  of  health  con- 
servation among  policyholders  and  have  applied 
this  principle  in  various  ways,  some  by  physical 
examinations  or  periodic  urinary  examinations, 
and  others  by  educational  measures  such  as  health 
bulletins. 

The  Institute  has  been  deliberate  in  extending 
this  life  insurance  work  and  has  appreciated  the 
importance  of  making  good  in  other  fields  wherever 
possible  in  order  that  the  work  may  not  be  halted 
by  the  educational  effort  required. to  convince  life 

Cia] 


insurance  officers  of  the  real  need  for  such  a  ser- 
vice. We  use  the  term  "need"  in  a  broad  sense. 
No  one  acquainted  with  life  insurance  affairs  ques- 
tions that  present  premium  rates  are  more  than 
adequate  to  cover  present  and  future  rates  of  mor- 
tality and  no  one  in  the  Institute  would  claim  that 
the  mortality"  rate  in  any  well  managed  company 
menaces  its  prosperity  or  stability. 

The  "need"  that  exists  in  relation  to  health  con- 
servation arises  from  the  public  conviction  that, 
following  the  war,  all  human  institutions  will  be 
expected  to  function  as  broadly  as  possible  for  the 
public  good.  If  a  life  insurance  company  can,  with- 
out impairing  in  any  way  its  ability  to  meet  its 
death  indemnity  contracts  or  without  increasing 
the  cost  of  such  contracts  to  the  public,  make  avail- 
able this  machinery  for  prolonging  human  life  and 
preventing  disease  and  disability,  there  will  surely 
be  a  public  expectation  that  the  business  of  life 
insurance  will  broaden  to  include  these  functions. 
If  there  is  a  further  prospect  of  effecting  mortality 
gains  from  such  measures,  the  insistent  principle  of 
conservation  of  man  power  and  of  all  national  re- 
sources demands  action  and  an  efficient  utilization 
of  such  opportunities. 

The  peculiar  nature  of  the  life  insurance  busi- 
ness has  always  given  it  more  than  a  commercial 
significance.  It  has  been  rightly  regarded  as  one  of 
the  great  social  bulwarks  against  poverty  and  its 
attendant  evils.  It  comes  as  a  message  of  hope  and 

[13] 


relief  in  the  darkest  hours  of  family  life.  It  is 
logical  and  entirely  consistent  that  there  should  be 
blended  with  this  business  of  life  insurance  the  ele- 
ment of  health  preservation,  disease  prevention 
and  death  postponement,  especially  as  the  inclu- 
sion of  these  functions  in  the  activities  of  the  busi- 
ness would  operate  both  to  popularize  and  finan- 
cially strengthen  the  institution. 

Believing  that  such  principles  would  ultimately 
be  accepted  in  the  life  insurance  world,  the  In- 
stitute did  not  press  its  campaign  strenuously 
among  the  companies,  especially  in  view  of  war 
conditions,  but  proceeded  to  develop  its  system 
where  it  could  be  done  most  readily  and  effectively, 
trusting  to  the  persuasion  of  success  to  appeal 
more  strongly  to  the  life  insurance  companies,  and 
also  to  the  growth  of  a  strong  public  urge  for  in- 
surance companies  to  broaden  their  usefulness  and 
engage  in  such  activities. 

In  accordance  with  its  original  purpose,  the  In- 
stitute has  established  a  specialized  organization 
which  is  equipped  to  render  a  standardized  service 
to  policyholders,  combining  the  periodic  examina- 
tion and  the  necessary  hygienic  instruction  and 
guidance  that  should  accompany  it. 

More  than  one  hundred  and  fifty  industrial  and 
commercial  concerns,  such  as  the  Guaranty  Trust 
Company  of  New  York,  Solvay  Process  Company, 
and  Standard  Oil  Company  of  New  York,  have 
taken  this  service  for  employees  and  a  very  large 

[14] 


individual  membership  has  also  been  established. 

The  growth  of  this  business  has  been  such  that 
it  now  occupies  two  floors  in  its  headquarters  in 
New  York,  where  it  employs  more  than  one  hun- 
dred people,  including  twenty  physicians.  A  large 
laboratory  has  been  established  with  complete 
equipment  for  all  forms  of  pathological  work.  This 
laboratory  serves  about  two  hundred  physicians  in 
New  York  and  vicinity  in  addition  to  carrying  on 
the  regular  laboratory  work  of  the  Institute.  A 
complete  X-Ray  department  is  also  included  in 
the  Head  Office  equipment. 

The  Institute  also  has  a  branch  office  in  Chicago 
and  more  than  five  thousand  examiners  in  the 
principal  towns  and  cities  in  the  United  States  and 
Canada. 

The  support  of  the  Hygiene  Reference  Board 
has  been  retained  and  its  scientific  interest  in- 
creased as  the  work  of  the  Institute  has  grown. 
This  board  has  rendered  extremely  important  ser- 
vice in  keeping  the  scientific  work  of  the  Institute 
in  equilibrium,  especially  with  regard  to  the  prin- 
ciples of  personal  hygiene  for  which  it  stands. 

This  aid  has  been  rendered  without  compensa- 
tion and  wholly  as  a  contribution  to  scientific 
advancement  and  public  welfare. 

More  than  one  hundred  and  thirty  thousand 
copies  of  the  Institute's  health  bible,  the  book 
"How  to  Live,"  have  been  sold,  and  several  of  the 
leading  universities  and  colleges  have  adopted  it  as 

[15] 


their  standard  book  on  hygiene,  and  the  special 
edition  of  this  book  entitled  "Health  for  the  Sol- 
dier and  Sailor,"  which  includes  chapters  on  war 
hygiene  and  sanitation  has  been  widely  distributed 
in  the  army  and  navy.  The  Surgeon-General  of  the 
Navy  instructed  that  it  be  placed  in  all  naval 
libraries.  The  royalties  from  the  book  "How  to 
Live"  have  been  devoted  wholly  to  philanthropic 
public  health  work,  the  most  notable  employment 
of  these  funds  being  in  the  distribution  to  the 
draft  boards  through  the  United  States  Public 
Health  Service  of  more  than  1,000,000  pamphlets 
of  instruction  for  registrants  rejected  in  the  draft. 

More  than  100,000  individuals  have  been  exam- 
ined in  the  individual,  group  and  insurance  service 
of  the  Institute,  and  in  the  course  of  this  work 
standardized  methods  of  examination  and  of  in- 
struction in  personal  hygiene  have  been  developed. 
It  is  evident,  therefore,  that  the  equipment  of  the 
Institute  enables  it  to  render  this  service  to  policy- 
holders in  a  more  complete  and  satisfying  way  than 
would  be  possible  for  a  single  life  insurance  com- 
pany. There  is  no  effort  to  separate  "good  risks" 
from  "bad  risks."  The  purpose  of  these  examina- 
tions is  to  make  a  spot  map  of  the  individual  as 
regards  his  physical  defects,  family  and  personal 
history  and  his  life  tendencies,  and  convey  counsel 
not  only  as  to  the  prevention  of  disease  and  dis- 
ability but  as  to  possible  increase  in  vitality. 

Apart  from  the  actuarial  study  presented  by 

[16] 


Mr.  C.  W.  Jackson  to  the  Actuarial  Society  of 
America,  October  16,  19 13,  on  a  special  group  of 
lives  that  came  under  a  similar  system  of  periodic 
examination,  there  has  been  no  complete  actuarial 
study  made  of  the  insurance  policyholders  that 
have  had  these  periodic  examinations.  The  diffi- 
culties of  such  an  analysis  are  well  understood, 
especially  with  regard  to  an  agreement  upon  stan- 
dard factors  for  comparison.  It  is  hoped,  however, 
that  such  a  study  will  soon  be  available. 

In  the  interval,  we  have  abundant  evidence  in 
the  form  of  collected  individual  cases,  showing  the 
successful  operation  of  this  principle,  and  we  have 
the  results  of  these  examinations  showing  the  de- 
gree of  impairment  that  is  found  and  the  obvious 
opportunity  for  relief  developed  by  this  examining 
system. 

The  following  is  a  typical  case  illustrative  of  the 
way  in  which  this  system  works: 

A  policyholder,  25  years  of  age,  when  first  examined  by  the 
Institute  was  not  aware  of  impairment  except  tendency  to 
catarrh.  He  weighed  213  pounds,  height, 5  ft.  10%  in.;  albumin 
present,  diastolic  blood  pressure  increased  to  108. 

On  second  yearly  examination  diastolic  blood  pressure 
reduced  below  100,  no  albumin,  weight  reduced  to  200  pounds. 

On  third  yearly  examination  blood  pressure  normal,  115 
systolic,  75  diastolic,  weight  reduced  to  normal  for  age,  170 
pounds,  a  total  reduction  of  43  pounds;  no  albumin  in  urine. 
These  changes  were  brought  about  by  simple  regulation  in 
diet,  and  exercise. 

That  this  man  is  in  a  much  more  favorable  mor- 

[17] 


tality  class  on  his  physical  showing  alone  cannot 
be  denied.  That  allowance  must  also  be  made  for 
his  recognition  of  the  need  for  guarding  against 
overweight  and  organic  strain  is  also  true.  There 
are  hundreds  of  such  cases  on  record  showing  the 
margin  of  possible  improvement  that  exists  among 
standard  policyholders. 

There  are  numerous  instances  of  co-operation  of 
this  type  and  it  must  be  evident  that  any  individ- 
ual who  takes  the  trouble  to  be  examined  would 
be  at  least  to  some  degree  co-operative  and  en- 
deavor to  profit  by  the  counsel  he  receives.  Prob- 
ably no  one  who  has  not  been  engaged  in  this  type 
of  work  can  appreciate  how  much  can  be  done  by 
personal  hygiene  alone  to  change  the  physical 
condition  or  life  trend  of  individuals  with  common 
types  of  impairments  or  departures  from  the  ideal 
of  health  which  we  too  often  accept  as  a  matter  of 
course. 

As  we  have  pointed  out,  the  policyholding  body 
of  any  company  is  made  up  of  a  mixture  of  types. 
Under  a  critical  and  careful  examination  none  will 
be  found  absolutely  free  from  impairment,  as  the 
intensive  work  done  by  the  Head  Office  staff  of  the 
Institute  among  large  groups  of  supposedly  healthy 
people  has  shown. 

On  the  opposite  page  is  an  analysis  of  typical 
industrial,  commercial  and  insurance  groups 
(figures  derived  from  more  than  10,000  cases): 

[18] 


INDUSTRIAL 

COMMERCIAL 

LIFE  INS 

MEN 
AVER. 
AGE 

34 

WOMEN 
AVER. 
AGE 

25 

MEN 
AVER. 
AGE 

26 

WOMEN 
AVER. 
AGE 

26 

AVER. 
AGE 

37 

No  physical  impairment  re- 
ported— no  modification  of 
living  habits  required 

% 

0 

% 
o 

O 

0 

% 
0 

Slight  physical  impairment 
or  defect  requiring  observa- 
tion or  hygienic  guidance. . 

10 

n 

10 

12 

6 

Moderate  physical   impair- 
ment  or   defect   requiring 
some  form  of  hygienic  guid- 
ance or  minor  medical,  den- 
tal or  surgical  treatment. . . 

42 

54 

52 

58 

63 

Moderate  physical  impair- 
ment or  defect,  medical  su- 

pervision or  treatment  ad- 
vised  in   addition   to   hy- 
gienic guidance 

35 
9 

19 

4 

27 
9 

21 

21 

Advanced  physical  impair- 
ment  or   defect   requiring 
systematic  medical  super- 

9 

7 

Serious  physical  impairment 
or  defect  urgently  demand- 
ing immediate  attention. . . 

4 

0 

2 

0 

3 

[19} 


Among  life  insurance  policyholders  more  than 
30  per  cent,  of  those  examined  required  important 
medical  attention  and  of  this  number  90  per  cent, 
were  unaware  of  any  important  impairment.  The 
periodic  examinations  of  life  insurance  policy- 
holders scattered  throughout  the  country  and  dis- 
tributed through  a  staff  of  5,000  physicians  has,  of 
course,  been  less  directly  supervised  and  less  in- 
tensively critical;  hence  the  results  are  not  abso- 
lutely comparable  with  those  of  the  Head  Office 
staff,  yet  they  reflect  similar  conditions  of  impair- 
ment. 

It  is  evident  from  such  figures  that  there  is 
abundant  opportunity  for  corrective  work  among 
insured  risks.  When  figures  of  this  nature  were  first 
produced  by  the  Institute  there  was  considerable 
astonishment  expressed  in  some  quarters.  There 
was  doubt  as  to  whether  the  work  had  not  been 
done  in  a  hypercritical  way.  The  fact  that  only 
10  to  15  per  cent,  of  applicants  for  insurance  are 
declined  obscured  the  problem.  Too  many  people 
have  been  accustomed  to  jump  to  the  conclusion 
that  those  accepted  for  life  insurance  are  practi- 
cally free  from  defect.  No  experienced  life  insur- 
ance reviewer  would  upon  reflection  endorse  such 
a  view. 

There  is  a  vast  range  of  defects,  disabilities  and 
impairments  which  are  not  recorded  in  a  life  in- 
surance examination,  yet  they  are  not  without 
their  effect  on  mortality.  They  are  disregarded 

[20] 


simply  because  life  insurance  premiums  cover  the 
risk  assumed.  It  is  probable  that  many  life  insur- 
ance men  of  experience  do  not  often  stop  to  re- 
flect on  the  reasons  why  it  is  necessary  so  rapidly 
to  increase  the  premium  rate  with  advancing  age. 
It  is  obvious,  of  course,  that  this  increase  is  almost 
entirely  necessitated  by  the  increasing  death  rate 
and  also  shorter  duration  of  premium  payments, 
but  why  the  death  rate  increases  is  seldom  in- 
quired into;  it  is  accepted  as  the  expression  of  a 
natural  law.  Also,  many  do  not  reflect  that  the  so- 
called  American  Experience  Table  is  really  an  arti- 
ficial table  constructed  many  years  ago  and  that  it 
could  not,  except  by  chance,  reflect  present  mor- 
tality conditions.  The  possibility  of  searching  out 
the  causes  that  produce  the  death  rate  and  modi- 
fying them  in  a  way  to  effect  mortality  gains  must 
be  apparent  to  anyone  who  critically  examines  the 
evidence  with  an  open  mind. 


[-1] 


The  following  chart,  derived  from  the  U.  S.  Life 
Tables  of  the  Census  of  1910,  abruptly  "hits  us  in 
the  face,"  as  it  were,  and  shows  how  rapid  is  the 
loss  in  vitality  after  age  12: 

Death  Rate  per  iooo  Living  Among  White  Males 

Cities  in  Original  Registration  States 

United  States  Life  Tables,  Census  of  1910 

36.   69.    137.   245.   386.   585.   D.R. 


18, 


12. 


4-5 


6.8 


70     80      90      100     106   ages 


D.R.  2.4 


AGES  12      20      30      4O      50      60 

Those  who  wish  to  believe  that  the  death  rate  at 
40  is  nearly  treble  what  it  is  at  20  because  of  a 
natural  law  are  welcome  to  such  a  belief,  but  we 
claim  that  the  more  scientific  attitude  of  mind  is  to 
assume  that  there  must  be  many  causes  at  work 
producing  this  increase  in  the  death  rate  which  are 

[22] 


to  some  degree  controllable  by  science.  As  a  mat- 
ter of  fact,  many  of  these  causes  have  been  ascer- 
tained and  neutralized  as  in  the  case  of  communi- 
cable and  epidemic  disease.  The  death  rates  at  the 
early  periods  of  life  have  been  profoundly  altered 
by  scientific  work;  indeed,  the  statistics  of  a  num- 
ber of  countries,  Sweden,  England  and  Wales 
show  a  substantial  decrease  in  the  death  rate 
at  every  age  period  of  life.  Evidence  is  lacking 
that  there  has  been  any  improvement  at  the 
elderly  ages  in  this  country;  in  fact,  the  reverse 
would  seem  to  be  the  case.  However  that  may 
be,  it  is  now  a  matter  of  almost  common  knowledge 
which  insurance  officers  cannot  afford  to  disregard, 
that  a  vast  amount  of  chronic  disease  and  prema- 
ture death  is  caused  by  infection,  by  faulty  living 
habits,  by  such  conditions  as  mouth  infection, 
constipation,  dietetic  excess,  overweight  and  like 
conditions  which  a  thorough  physical  examination 
can  reveal  and  which  hygienic  government,  medi- 
cal, dental  or  surgical  treatment  can  mitigate, 
control  or  cure. 

It  is  also  true  that  these  are  the  very  types  of 
impairment  that  are  disregarded  in  a  life  insur- 
ance examination  unless  they  are  present  in  a 
most  extreme  and  menacing  degree;  hence  it  is 
quite  clear  that  in  every  policyholding  body  these 
factors  are  constantly  at  work  keeping  the  death 
rate  much  above  what  it  need  be  if  reasonable 
attention   is   given   to   detecting   and   correcting 

[23] 


these  impairments  and  improving  faulty  living 
habits. 

It  may  come  as  a  shock  to  some  insurance  offi- 
cers to  be  told  that  the  influence  of  the  present  in- 
surance system  is  rather  to  encourage  physical 
neglect  and  increase  mortality  than  to  the  contrary. 

A  man  who  has  been  accepted  for  life  insurance 
is  inclined  to  slap  himself  on  the  chest  and  be  con- 
firmed in  any  physical  neglect  of  which  he  may  be 
guilty.  It  is  not  uncommon  for  the  examining  phy- 
sician to  tell  him,  as  contribution  to  the  amenities 
of  the  occasion,  that  he  is  "the  finest  specimen  of 
physical  manhood  that  he  has  ever  examined." 
Learning  that  his  various  sins  against  his  body 
have  apparently  been  without  any  ill  effect,  he 
continues  to  commit  them.  He  regards  his  exami- 
nation as  giving  him  what  is  known  as  a  "clean 
bill  of  health."  That  the  average  accepted  risk  is 
actually  far  from  being  entitled  to  a  clean  bill  of 
health  is  shown  by  any  regular  system  of  examin- 
ing that  takes  into  account  the  factors  hereinbe- 
fore mentioned  which  have  been  scientifically 
demonstrated  materially  to  influence  health  and 
longevity,  even  though  in  the  mass  they  do  not 
call  for  sub-standard  premium  rates. 

At  certain  ages  mortality  rates  have  altered  very 
materially  for  the  better  in  the  past  thirty  years 
and  they  are,  at  all  ages,  as  we  have  frequently 
contended,  subject  to  very  considerable  control  by 
scientific  methods. 

t>4] 


It  is  true  that  insurance  examinations  have  also 
saved  many  lives  in  that  they  have  made  known 
to  impaired  individuals  who  have  been  rejected 
the  fact  that  they  require  some  change  in  their 
method  of  living  or  some  form  of  medical  treat- 
ment. We  have  known  of  many  such  instances  and 
all  such  instances  tend  strongly  to  confirm  the 
value  of  periodic  examinations. 

We  believe  that  the  idea  that  risks  accepted 
for  life  insurance  are  on  the  average  of  such  a 
high  quality  that  there  is  little  opportunity  for 
improvement  and  that  the  expense  of  periodic 
examinations  would  not  be  justified  has  had  a  very 
profound  influence  on  the  views  of  some  life  insur- 
ance experts;  in  fact,  at  the  time  of  the  organiza- 
tion of  the  Institute  this  criticism  was  made  by  a 
very  able  life  insurance  officer  who  now  views  with 
favor  the  general  development  of  the  Institute. 
He  contended  that  a  very  small  proportion  of  in- 
dividuals would  be  found  in  the  average  insurance 
company  whose  mortality  could  be  materially  in- 
fluenced. 

Since  then  a  wealth  of  information  has  become 
available  with  regard  to  the  causation  of  disease, 
especially  as  to  the  role  of  focal  infection  in  causing 
chronic  disease  and  those  gradually  ageing  pro- 
cesses which  are  not  dignified  by  the  name  of 
disease  yet  still  contribute  to  the  death  rate  in  the 
middle  and  later  periods  of  life.  With  our  present 
broader  knowledge  of  the  conditions  actually  ex- 

[25] 


isting  among  average  groups  of  people  and  even 
among  selected  insured  lives  and  of  the  actual  per- 
centages of  impairments  found  among  the  groups 
of  lives  examined  by  the  Institute,  a  substantial 
margin  of  possible  improvement  among  standard 
risks  is  clearly  shown. 

That  the  figures  derived  from  the  Life  Extension 
Institute's  examinations  of  industrial  groups  and 
of  policyholders  are  not  the  reflection  of  a  hyper- 
critical or  exaggerated  viewpoint  is  shown  by  the 
results  of  the  recent  draft  examinations. 

Acting  for  one  of  the  committees  of  the  Medical 
Section  of  the  Council  of  National  Defense,  the 
Medical  Director  of  the  Institute  made  an  investi- 
gation of  the  results  of  the  examinations  in  a  num- 
ber of  representative  boards  and  collected  the  data 
exhibited  in  the  table  shown  below: 


ANALYSIS  OF  SEVEN  LOCAL  DRAFT  BOARDS  IN 
DETROIT,  BROOKLYN  AND  NEW  YORK 

PERCENTAGE 
NUMBER  OF  MEN 

EXAMINED 

Number  of  men  called 8,875  .... 

Number  of  men  examined 7,61 1  .... 

Number  of  men  discharged  for  physical 

reasons 2>232  29 

Prominent  Causes  of  Rejection: 

Defective  Eyes 462,  6 . 

Defective  Teeth 366  4 . 8 

Underweight 350  4.6 

[Continued  on  page  27] 
[26] 


Hernia 223  2 . 9 

Defective  Heart 184  2.4 

Defective  Feet 180  2.3 

Injured  or  amputated  limbs 169  2.2 

Defective  Ears 88  1.2 

Tuberculosis  of  lungs 77  1 . 

Tuberculosis  of  joints 2  .... 

Undersize 53  .7 

Genito-urinary,  bladder,  etc 37  .5 

Varicose  veins 3$  .4 

Overweight 32  .4 

Syphilis 32  .4 

Varicocele 28  .3 

Deformity  of  trunk 38  .5 

Asthma,  bronchitis,  etc 21  .3 

Mental  and  insane 14  .2 

Debility  and  poor  physique 16  .2 

Miscellaneous  injuries 15  .2 

Hemorrhoids 13  .2 

Kidney  disease 10  .1 

Rheumatism 8  .1 

Miscellaneous  defects 7  .1 

Epilepsy 7  .1 

Fistula 5  .06 

Alcoholism 4  .05 

Hydrocele 4  .05 

Diabetes 4  .05 

Goiter 6  .08 

Deaf  mutes 6  .08 

Skin  affections 4  .05 

Liver  and  gallbladder  disease 3  .04 

Drug  habit 3  .04 

Injury  to  nervous  system 3  .04 

Kidney  removed 2  .02 

Neurasthenia 1  .01 

[17] 


The  rejection  rate  in  these  local  boards,  29  per 
cent.,  was  exactly  in  agreement  with  the  rejection 
rate  found  for  the  entire  country,  as  shown  by  the 
Provost  Marshal  General's  preliminary  report  of 
the  first  draft,  subsequently  issued. 

Total  called 3,082,946 

Total  examined  by  local  beards 2,510,706 

Total  rejected  by  local  boards  for  physical 

reasons  73°>756 

Percentage  of  those  examined 29 . 1 1 

Add  5.8  per  cent,  rejected  at  cantonments 

(estimated) 33 . 1 

The  following  table  appears  in  the  second  report 
of  the  Provost  Marshal  General,  February  19 19. 

PER  CENT. 

Percentage  of  rejections  by  local  boards  in  191 7 29.11 

Percentage  in  191 8,  groups  B,  C,  D  [Table  49] 29-59 

Percentage  of  camp  rejections  of  local  board  accept- 
ances, 1917 5.80 

Percentage  in  191 8  [Table  56] 8.10 

It  will  be  noted  that  approximately  38  per  cent,  of 
the  total  number  examined  in  the  second  draft  were 
declined  for  active  service  for  physical  reasons. 
Examinations  in  the  U.  S.  Navy  and  Marine  Corps 
are  even  more  emphatic  in  their  testimony  as  to 
the  degree  of  physical  impairment  that  exists  in 
the  population. 


[28] 


ANALYSIS  OF  PHYSICAL  CAUSES 

FOR  REJECTION  FOR  MILITARY  SERVICE 

U.  S.  NAVY  AND  MARINE  CORPS 

(Report  of  Surgeon-General,  1916) 


Number  of  applicants 113,932 

Number  of  men  examined 82,592 

Number  of  men  rejected  for  all  causes  51,167 
Causes  of  Rejection: 

Eye  defects 9,452 

Underweight 5,397 

Flatfoot 5,028 

Defective  teeth 4,878 

Deformities 3>533 

Varicocele  or  varicose  veins 3,105 

Heart  affections 2,302 

Height,  under 2,124 

Poor  physique 1^>33 

Ear  defects I>37^> 

Genito-urinary- venereal ij347 

Hernia,  or  tendency  to 1,312 

Skin  disease 1,094 

Height  and  weight,  under 921 

Tuberculosis  or  suspects 909 

Pyorrhea 896 

Tonsillar  conditions 588 

Genito-urinary,  non-venereal 548 

Nasal  abnormalities 476 

Febrile  conditions 381 

Mental  disorders 302 

Goiter  or  tendency  to 294 

Defective  speech 132 

Miscellaneous  causes 2,820 


PERCENTAGE 

OF  MEN 

EXAMINED 


62 
II 

6 
6 

5 

4 

3 
1 
2 
2 
1 
1 
1 
1 
1 
1 
1 


6 

o 

7 
6 
6 

3 
1 
1 

08 
72 
66 

51 
46 

S^ 
35 
l5 
41 


When  we  reflect  that  these  rejections  cover  in- 
dividuals impaired  to  a  degree  that  made  them 
unfit  even  for  training  or  remedial  treatment  at  the 
camps,  as  then  equipped,  an  even  larger  estimate 
is  possible  of  the  actual  degree  of  impairment 
that  exists. 

Notwithstanding  the  close  of  the  war,  there  can 
be  no  question  as  to  the  tremendous  importance 
of  conserving  our  man  power.  World  conditions  at 
the  present  time  and  for  generations  to  come  im- 
peratively demand  that  we  give  this  matter  seri- 
ous consideration.  The  best  minds  in  the  country- 
are  now  busy  with  these  problems,  striving  to  es- 
tablish methods  of  physical  education  and  train- 
ing for  the  young,  rehabilitation  for  the  wounded 
or  impaired  soldier,  and  medical  care  and  physical 
supervision  for  the  industrial  employee.  The  war 
has  given  an  immense  stimulus  to  such  activities. 

The  Institute  is  participating  in  this  work  in 
various  ways  and  particularly  in  its  services  to 
large  industrial  concerns  through  which  the  health, 
working  capacity  and  morale  of  the  workers  are 
improved. 

The  insurance  companies  have  channels  of  direct 
communication  with  practically  every  household 
in  the  land.  Their  influence  on  these  households 
can  be  greatly  increased  by  fully  utilizing  these 
channels  of  communication.  The  public  will  regard 
such  activities  as  a  wholesome  and  legitimate  func- 
tion of  life  insurance,  if  the  information  is  safe- 

[3°] 


guarded  and  held  as  confidential  and  utilized  solely 
for  prolonging  life.  Also  the  psychological  effect  of 
this  system  on  the  policyholding  body  is  entirely 
favorable,  especially  if  it  be  operated  through  a 
public  service  institution  like  the  Institute,  which 
can  give  guarantees  that  its  interest  is  primarily 
directed  to  the  benefit  of  the  policyholder.  Many 
who  do  not  take  the  examinations  nevertheless  ap- 
prove of  the  company's  action.  Others,  influenced 
by  the  company's  action,  take  these  examinations 
through  their  own  physicians.  A  self-selected  group 
in  the  policyholding  body  will  actually  take  the 
examinations  offered  by  the  company.  This  group 
is,  of  course,  the  one  most  needing  such  a  service 
and  affords  the  largest  opportunity  for  conveying 
relief  and  lowering  mortality.  These  psychological 
factors  automatically  limit  the  acceptances  in  pro- 
portion to  the  size  of  the  company. 

We  feel  that  because  of  the  broad  work  that  the 
Institute  is  doing  throughout  the  population  it  is 
entitled  to  the  cordial  co-operation  of  the  life  in- 
surance companies.  Many  of  our  individual  mem- 
bers are  life  insurance  risks,  and  in  any  industrial 
or  commercial  group  that  we  examine  there  is  a 
large  proportion  of  life  insurance  risks.  Our  service 
is  favorably  influencing  these  lives  and  rendering 
them  more  desirable  risks.  We  feel,  therefore,  that 
there  is  every  reason  why  life  insurance  companies 
should  be  willing  to  take  a  cordial  interest  in  our 
work  and  critically  examine  our  facilities  for  serv- 

[30 


ing  them,  or  at  least  consider  in  what  way  they 
may  individually  contribute  to  the  improvement 
of  national  vitality. 

As  we  have  said  before,  we  are  making  exami- 
nations of  employees  in  hundreds  of  business  con- 
cerns. There  are  thousands  of  concerns  that  should 
have  this  service.  In  every  concern  which  we  exam- 
ine a  majority  of  the  people  are  policyholders. 
Your  company  is  getting  its  share  of  the  profits 
that  result  from  the  help  we  give  these  people, 
without  one  cent  of  expense  to  you.  Is  it  not  sound 
business  policy  to  encourage  the  extension  of  this 
work?  We  find  the  best  recommendation  we  can 
have  with  industrial  concerns  is  the  endorsement 
of  old-line  insurance  companies.  Another  reason 
why  the  Institute  should  command  the  good  will 
and  active  support  of  insurance  companies  is  that 
after  allowing  5  per  cent,  on  its  preferred  stock 
two-thirds  of  its  profits  are  used  for  public  health 
propaganda. 


[32] 


PLANS  AND  METHODS 

The  Institute   has   arranged   three  types  of 
services  for  insurance  companies. 

First — Urinary  Analysis,  Personal  Questionnaire, 
Hygienic  Counsel  and  Educational  Service 

We  have  designed  a  very  economical  low  cost 
service  that  companies  can  use  who  wish  to  do 
something  along  this  line  but  desire  to  keep  the 
amount  expended  down  to  a  minimum. 

This  service  consists  in  offering  the  policyholder 
a  membership  in  the  Institute  which  entitles  him 
to  a  confidential  review  of  a  personal  history  ques- 
tionnaire, a  urinary  examination  at  our  head  office 
laboratory  and  a  quarterly  magazine  containing 
the  essentials  of  our  monthly  magazine. 

Policyholders  desiring  the  service  fill  out  an  ap- 
plication slip  which  has  been  received  in  the  prem- 
ium notice  and  forward  it  to  the  insurance  com- 
pany. The  company  then  forwards  to  the  policy- 
holder the  blank  questionnaire,  with  instructions  to 
fill  it  out  and  forward  to  the  Institute,  together 
with  a  specimen  of  urine  in  a  container  which  the 
Institute,  on  notice  from  the  company,  has  sent  to 
the  policyholder.  All  the  data  derived  from  this 
source  is  reviewed  at  our  Head  Office,  and  a  report 
sent  to  the  policyholder  with  appropriate  recom- 
mendations and  Keep-Well  leaflets  of  instruction. 

133} 


We  recommend  that  this  service  be  held  as  strictly 

confidential  between  policyholder  and  the  Institute. 

The  charge  for  this  service  is  one  dollar  per  annum. 

Second — Examining  and  Educational  Service 
for  Entering  Policyholders. 

This  service  is  designed  to  make  the  maximum 
use  of  the  information  in  the  application  and  medi- 
cal report  apart  from  its  use  for  selection  purposes. 

Heretofore  there  has  been  no  effort  made  to 
change  the  type  of  risk  as  it  goes  upon  the  books. 
It  is  well  known  that  so-called  standard  risks  vary 
widely  in  their  mortality,  depending  upon  the 
type.  The  Medico-Actuarial  Investigation  has 
shown  that  many  types  of  risks  accepted  as  stan- 
dard have  exhibited  a  mortality  above  the  Ameri- 
can Experience  Table.  The  mortality  of  a  company 
is  always  derived  from  these  types  included  be- 
tween the  two  extremes  of  super-standard  and 
borderline  risks.  There  is  abundant  opportunity 
favorably  to  influence  the  mortality  among  the 
borderline  risks,  and  even  the  standard  risks  can 
be  greatly  improved.  Inasmuch  as  these  mortality 
figures  are  not  fixed  by  some  immutable  law,  but 
are,  as  we  have  shown,  the  result  of  definite  mate- 
rial causes  which  are  subject  to  modification,  fail- 
ure to  attempt  the  modification  must  be  regarded 
as  a  neglected  business  opportunity. 

We  have  innumerable  instances  of  these  border- 
line types;  overweights  who  have  transformed  their 

[34] 


condition  by  diet  and  entered  a  more  favorable 
mortality  class.  A  long  range  of  troubles  which 
have  their  influence  on  mortality  yet  are  not  suf- 
ficient to  exclude  from  standard  insurance,  can  be 
given  attention  in  this  service  and  the  life  trend  of 
the  policyholder  often  very  materially  altered  for 
the  better. 

The  plan  is  to  forward  to  the  policyholder  with 
his  policy  a  circular  offering  him  a  membership  in 
the  Life  Extension  Institute,  telling  him  something 
of  its  purposes  and  personnel;  that  the  company 
has  investigated  its  standing  and  can  vouch  for  its 
management  and  that  every  recommendation  it 
may  make  should  receive  serious  consideration.  A 
personal  history  form  is  enclosed  in  which  the 
policyholder  is  offered  the  privilege  of  a  confidential 
review  of  his  physical  condition  and  manner  of 
living  by  the  Life  Extension  Institute  without 
charge  to  him.  The  policyholder  fills  out  the  ques- 
tions relating  to  hygiene  on  this  blank,  which  is  re- 
turned to  the  company.  The  company  then  places 
a  brief  digest  of  the  physical  findings  on  the  form 
and  forwards  it  to  the  Institute.  The  papers  are 
reviewed  by  a  specialist  in  charge  of  this  work  — 
the  errors  in  hygiene  noted,  the  physical  defects, 
such  as  overweight,  hemorrhoids,  mouth  infection, 
underweight,  constipation  or  other  conditions 
reported,  and  a  personal  letter  of  counsel  is  written 
suggesting  such  modification  in  living  habits  as  may 
be  indicated orsuchmedical,  dental  or  surgical  atten- 

[35] 


tion  as  would  improve  the  condition  of  the  risk. 
The  urinary  service  described  in  the  previous  sec- 
tion is  offered  the  policyholder  at  the  end  of  a  year 
and  another  letter  of  congratulation  or  advice  sent 
him,  based  upon  the  findings. 

The  policyholder  also  receives  the  monthly 
magazine  "How  to  Live,"  and  in  connection  with 
the  letter  of  advice,  such  Keep-Well  leaflets  as 
apply  to  his  case.  This  educational  and  life-pro- 
longing service  introduces  a  special  feature  which 
should  prove  of  "business  getting"  advantage  and 
constitute  a  powerful  "good-will"  factor.  Inasmuch 
as  the  service  is  not  compulsory,  only  those  who 
have  confidence  in  its  good  faith  will  take  it,  and 
such  people  will  be  co-operative  and  more  likely  to 
benefit  by  the  counsel  received.  Here  again  there 
is  a  certain  psychology  of  selection,  and  the  benefit 
of  this  service  will  be  automatically  extended  to 
those  who  need  it  most. 

One  interesting  feature  of  this  service  is  the  fact 
that  while  the  application  and  medical  report  may 
reveal  very  little  of  importance,  the  policyholder, 
when  interest  in  his  condition  is  aroused,  will  very 
frankly  reveal  his  so-called  minor  troubles,  such  as 
headache,  constipation,  and  symptoms  which  are 
not  usually  brought  out  in  a  life  insurance  exami- 
nation, yet  point  to  errors  in  living  and  even  to 
physical  defects,  the  correction  of  which  may  pro- 
foundly alter  the  trend  of  the  individual.  At  least 
we  are  educating  policyholders  and  their  families 

[36] 


to  the  need  of  periodic  examinations  by  competent 
physicians. 

Policyholders  taking  this  service  are  privileged 
to  write  to  the  Institute  regarding  matters  of 
hygiene  and  disease  prevention. 

The  charge  for  this  service  is  two  dollars  for  the 
first  year  and  one  dollar  for  the  second. 

Third — Periodic  Examining  and 
Educational  Service. 

The  privilege  of  an  examination  at  intervals 
varying  according  to  the  choice  of  the  company 
from  one  year  to  three  years,  is  the  basis  of  this 
service.  The  details  of  this  service  are  as  follows: 

The  company  issues  with  its  premium  notices  a 
leaflet  notifying  the  policyholder  that  he  has  the 
privilege  of  a  confidential  physical  examination  by 
the  Life  Extension  Institute  for  the  purpose  of 
prolonging  his  life  and  improving  his  physical  con- 
dition. This  leaflet  contains  a  form  of  application 
which  the  policyholder  fills  out  if  he  desires  the 
examination  and  forwards  to  the  Head  Office  of 
the  insurance  company.  The  insurance  company 
then  notifies  the  Institute  and  a  personal  history 
form  is  forwarded  to  the  policyholder  with  a  re- 
quest that  he  call  upon  the  physician  named  there- 
in for  examination. 

The  local  physician  of  the  Institute  then  makes 
the  examination  and  forwards  the  report,  together 
with  the  personal  history  form,  to  the  Head  Office 

[37] 


of  the  Institute.  The  policyholder  also  forwards  a 
specimen  of  urine  to  the  Institute.  The  papers  are 
there  reviewed  as  is  the  case  in  the  service  for 
entering  policyholders,  and  a  report  made  to  the 
policyholder  of  his  physical  condition,  with  counsel 
as  to  his  needs.  Keep-Well  leaflets  are  also  included 
in  this  service  and  a  quarterly  health  journal  con- 
taining the  essentials  of  the  monthly  journal  "How 
to  Live." 

This  examination  is  along  the  standard  lines 
established  by  the  Institute,  and  includes  a  com- 
plete bodily  survey — eye,  ear,  nose,  throat,  blood 
pressure,  heart,  lungs,  nervous  system,  physical 
measurements,  and  an  examination  of  a  specimen 
of  urine  at  the  Head  Office  laboratory. 

The  charge  for  this  service  is  four  dollars  per  annum 
for  those  who  take  it. 

Some  companies  follow  the  plan  of  taking  the 
entering  service  for  policyholders  for  two  years, 
and  on  the  third  anniversary  extend  the  privilege 
of  periodic  examination. 

We  have  a  fifteen  dollar  service  that  we  feel  a 
company  could  afford  to  offer  to  its  policyholders 
carrying  #>  10,000  to  $50,000  insurance,  and  a  thirty- 
five  dollar  service  which  could  be  offered  to  persons 
carrying  over  $50,000.  These  services  provide  more 
elaborate  laboratory  tests  and  a  much  more  com- 
plete report  is  given  than  is  possible  with  a  four 
dollar  service. 

The  number  of  important  and  wealthy  business 

[38] 


men  who  have  manifested  interest  and  satisfaction 
in  the  service  rendered  them  by  the  Institute,  war- 
rants the  belief  that  such  a  privilege  would  be 
much  appreciated,  and  not  without  its  influence  on 
prospective  large  insurers. 

The  number  of  policyholders  who  will  take  these 
various  services  in  any  one  company,  notwithstand- 
ing the  fact  that  it  is  offered  free,  is  limited,  and 
the  total  burden  of  expense  is  not  heavy,  yet  the 
concentration  of  work  on  a  group  of  policyholders 
who  are  interested  in  benefiting  by  it,  makes  it 
worth  while  and  materially  assists  in  spreading 
these  principles  throughout  the  population  and 
encouraging  the  custom  of  periodic  examination 
whether  or  not  it  be  secured  through  a  life  insur- 
ance company. 

The  Institute  recommends  that  the  information 
derived  from  these  examinations  be  held  as  strictly 
confidential  between  the  policyholder  and  the  In- 
stitute and  that  such  information  be  available  to 
the  insurance  company  only  for  statistical  analysis 
of  the  results  and  not  for  individual  consideration. 

If  this  assurance  is  given  to  policyholders,  it 
allays  any  latent  feeling  on  their  part  that  such 
records  might  be  in  any  way  utilized  for  impairing 
their  insurance  standing.  While  all  who  have  inti- 
mate knowledge  of  present  insurance  management 
have  no  misgivings  on  that  score  and  are  well  aware 
that  in  all  well  managed  insurance  companies  the 
effort  is  made  to  prevent  lapses  and  hold  policy- 

l39l 


holders  on  the  books  regardless  of  whether  they 
are  impaired  or  not,  it  is  impossible  wholly  to  re- 
move from  the  public  mind  a  latent  feeling  of  this 
character,  and  this  applies  to  the  policyholders 
even  of  the  leading  companies. 

This  is  an  important  reason  why  an  organization 
like  the  Life  Extension  Institute  should  carry  on 
this  work  wholly  dissociated  from  the  ordinary 
business  activities  of  the  insurance  company  and 
maintained  in  an  atmosphere  devoted  solely  to 
the  improvement  of  the  physical  condition  of  the 
policyholder  and  the  prolongation  of  his  life.  A 
much  wider  utilization  of  this  service  can  be  as- 
sured where  it  is  carried  on  in  this  way.  - 

This  does  not  preclude  the  investigation  by  an 
insurance  company  of  the  mortality  it  sustains 
among  thisclassor  from  making  any  scientific  analy- 
sis it  may  desire  of  the  results  of  these  examinations. 

The  gradual  education  and  training  of  physi- 
cians to  make  these  examinations  along  standard- 
ized lines,  keeping  in  mind  the  viewpoint  of  hy- 
giene rather  than  insurance  selection,  is  a  fur- 
ther reason  why  the  work  should  be  done  by  a 
central  organization  wholly  devoted  to  such  a  task. 
As  the  business  develops  and  economies  are  intro- 
duced, made  possible  by  such  a  central  organiza- 
tion, the  Institute  would  expect  the  cost  of  doing 
the  work  to  be  reduced,  and  this  saving  shared  with 
the  insurance  companies. 

For  example,  the  reduplication  of  examinations, 

[40] 


that  is,  the  expense  of  examining  a  policyholder 
insured  in  a  number  of  companies  could  be  reduced 
by  distributing  the  charge  among  the  companies 
taking  the  service  of  the  Institute. 

At  any  time  that  the  volume  of  such  work  war- 
rants adjustment,  the  savings  from  this  source 
would  be  shared  with  the  insurance  companies. 


[41] 


CONCLUSION 

WE  have  found  that  most  insurance  officers 
are  genuinely  interested  in  the  general  pur- 
pose of  the  Institute  and  are  anxious  to  assist  in 
extending  its  work. 

The  object  of  this  book  is  to  give  a  comprehen- 
sive idea  of  the  lines  along  which  we  are  moving, 
in  the  hope  that  it  may  stimulate  some  companies 
frankly  to  join  hands  with  the  Institute  and  take 
its  service,  and  perhaps  others  to  co-operate  in  spe- 
cial ways  or  to  carry  on  this  work  themselves  in 
accordance  with  their  best  judgment. 

The  field  is  open  and  offers  vast  opportunities 
for  increasing  the  benefits  of  life  insurance  and 
greatly  extending  its  influence  among  the  people. 

It  is  really  a  higher  service  to  keep  a  policyholder 
alive  than  to  pay  a  moiety  of  his  financial  worth  to 
his  family  after  his  death.  These  two  services  can 
be  combined.  What  is  the  argument  against  it? 
We  would  welcome  an  expression  of  your  views. 
Bear  in  mind  that  it  is  being  done,  and  has  been 
done,  during  the  past  five  years — a  sufficient  an- 
swer to  many  former  objections  on  the  ground  that 
it  could  not  be  done.  Our  minds  are  open,  however, 
and  we  cordially  invite  suggestions,  criticisms,  and 
counsel. 


u*] 


Hygiene  Reference  Board 

OF  THE  LIFE  EXTENSION  INSTITUTE 
Irving  Fisher,  Chairman 

PROFESSOR  OF  POLITICAL  ECONOMY,  YALE  UNIVERSITY 

PUBLIC  HEALTH  ADMINISTRATION 

Hermann  M.  Biggs,  M.D.,  Commissioner  of  Health,  State  of  New  York. 

Rupert  Blue,  M.D.,  Surgeon-General,  U.S.  Public  Health  Service. 

H.  M.  Bracken,  M.D.,  Secretary,  Board  of  Health,  State  of  Minnesota. 

Admiral  William  C.  Braisted,  Surgeon-General,  U.  S.  Navy. 

Oscar  Dowling,  M.D.,  President,  Board  of  Health,  State  of  Louisiana;  Pro- 
fessor of  Hygiene,  Tulane  University,  New  Orleans. 

Maj.  Haven  Emerson,  M.D.,  M.  C,  U.  S.  A. 

Lieut.-Col.  John  S.  Fulton,  M.D.,  M.  C,  U.  S.  A.,  Secretary,  Depart- 
ment of  Health,  State  of  Maryland. 

S.  S.  Goldwater,  M.D.,  Director,  Mt.  Sinai  Hospital,  New  York. 

Maj.-Gen.  William  C.  Gorgas,  Surgeon-General,  U.  S.  Army.  (Retired) 

Calvin  W.  Hendrick,  Chief  Engineer,  City  of  Baltimore. 

J.  N.  Hurty,  M.D.,  Secretary,  Board  of  Health,  State  of  Indiana. 

Miss  Julia  Lathrop,  Chief,  Children's  Bureau,  U.  S.  Department  of  Labor, 
Washington,  D.  C. 

Allan    J.   McLaughlin,    M.D.,  Assistant  Surgeon-General,  U.  S.   Public 
Health  Service 

W.  S.  Rankin,  M.D.,  Secretary  and  Treasurer,  Board  of  Health,  State  of 
North  Carolina. 

Joseph   W.    Schereschewsky,   M.  D.,  Assistant  S  urge  on-General,   U.    S. 
Public  Health  Service 

George  C.  Whipple,  Professor  of  Sanitary  Engineering,  Harvard  University. 

MEDICINE  AND  SURGERY 

Lewellys  F.  Barker,  M.D.,  Professor  of  Medicine,  Johns  Hopkins  Univer- 
sity. 

George  Blumer,  M.D.,  Dean,  Yale  Medical  School. 

L.  Duncan  Bulkley,  M.D.,  Senior  Physician,  New  York  Skin  and  Cancer 
Hospital. 

Col.    George  W.  Crile,  M.D.,  M.  C,  U.  S.  A.,  Professor  of  Surgery, 
Western  Reserve  University. 

David  L.  Edsall,  M.D.,  Professor  of  Clinical  Medicine,  Harva-d  University. 


[43] 


Rear-Admiral  Cary  T.  Grayson,  M.D.,  U.  S  Navy. 

Maj.  Seale  Harris,  M.  C,  U.  S.  A.,  Professor  of  Medicine,  University 
of  Alabama. 

Capt.  S.  Adolphus  Knopf,  M.D.,  M.  C,  U.  S.  A.,  Professor  of  Medicine, 
Department  of  Phthisiotherapy,  New  York  Post  Graduate  Medical 
School. 

J.  H.  Kellogg,  M.D.,  Superintendent,  Battle  Creek  Sanitarium. 

Col.  William  J.  Mayo,  M.  D.,  M.  C,  U.  S.  A.,  Ex-President,  American 
Medical  Association. 

Maj.  Robert  Tunstall  Taylor,  M.  C,  U.S.A.,  Professor  of  Orthopaedic 
Surgery,  University  of  Maryland;  Surgeon-in-Chief,  Kernan  Hospital 
for  Crippled  Children. 

Col.  Victor  C.  Vaughan,  M.D.,  M.  C,  U.  S.  A.,  Dean,  Department  of 
Medicine  and  Surgery,  University  of  Michigan;  Ex-President,  American 
Medical  Association. 

Maj.  William  Holland  Wilmer,  M.D.,  M.  C,  U.  S.  A.,  Professor  of 
Ophthalmology,  Georgetown  University,  School  of  Medicine. 

Col.  Hugh  Hampton  Young,  M.D.,  M.  C,  U.  S.  A.,  Associate  Professor 
of  Urological  Surgery,  Johns  Hopkins  University. 

CHEMISTRY,  BACTERIOLOGY,  PATHOLOGY 
PHYSIOLOGY,  BIOLOGY 

John  F.  Anderson,  M.D.,  Lecturer  on  Personal  Hygiene  and  Sanitation,  Rut- 
gers College,  formerly  Director,  Hygienic  Laboratory ,  United  States  Gov- 
ernment. 

Maj.  Walter  B.  Cannon,  M.D.,  M.  C,  U.  S.  A.,  Professor  of  Physiology, 
Harvard  University. 

Russell  H.  Chittenden,  Prof  essor  of  Physiological  Chemistry ,  Director ,  Shef- 
field Scientific  School,  Yale  University. 

Otto  Folin,  Professor  of  Biological  Chemistry,  Harvard  Medical  School. 

M.  E.  Jaffa,  Professor  of  Nutrition,  University  of  California. 

E.  V.  McCollum,  Professor  of  Physiological  Chemistry,  School  of  Hygiene  and 
Public  Health,  Johns  Hopkins  University,  Baltimore,  Md. 

Lafayette  B.  Mendel,  Professor  of  Physiological  Chemistry,  Sheffield  Scien- 
tific School,  Yale  University. 

Richard  M.  Pearce,  M.D.,  Secretary,  Medical  Advisory  Committee,  American 
Red  Cross;  Professor  of  Research  Medicine,  University  of  Pennsylvania. 

Lieut.-Col.    Mazyck  P.    Ravenel,    M.  D.,  M.  C,  U.    S.  A.,   Director 

Laboratory  of  Hygiene,  Professor  of  Preventive  Medicine  and  Bacteriology, 
University  of  Missouri. 

Leo  F.  Rettger,  Professor  of  Bacteriology  and  Hygiene,  Sheffield  Scientific 
School,  Yale  University. 


[44] 


Maj.  M.  J.  Rosenau,  M.D.,  M.  C,  U.  S.  A.,  Professor  of  Preventive  Medi- 
cine, Harvard  Medical  School. 

Edward  C.  Rosenow,  M.D.,  Professor  of  Experimental  Bacteriology,  Univer- 
sity of  Minnesota  and  Mayo  Foundation. 

William  T.  Sedgwick,  Prof  essor  of  Biology  and  Public  Health,  Massachusetts 
Institute  of  Technology. 

Henry  C.  Sherman,  Professor  of  Food  Chemistry,  Columbia  University. 

Maj.  Theobald  Smith,  M.D.,  M.  C,  U.  S.  A.,  Director,  Division  of  Animal 
Pathology,  Rockefeller  Institute  for  Medical  Research. 

Charles  W.  Stiles,  M.D.,  U.  S.  Public  Health  Service. 

A.  E.  Taylor,  M.D.,  Professor  of  Physiological  Chemistry,  University  of 
Pennsylvania;  Assistant  to  the  Secretary  of  Agriculture. 

Col.  William  H.  Welch,  M.D.,  M.  C,  U.  S.  A.,  Dean,  School  of  Hygiene  and 
Public  Health,  Johns  Hopkins  University,  Baltimore,  Md. 

C.  E.  A.  Winslow,  Anna  M.  R.  Lauder,  Prof  essor  of  Public  Health,  Yale  Uni- 
versity; Curator,  Museum  Natural  History,  New  York. 

Francis  Carter  Wood,  M.D.,  Director  of  Cancer  Research,  Columbia  Uni- 
versity, in  the  City  of  New  York. 


STATISTICS 
Henry  W.  Farnam,  Professor  of  Economics,  Yale  University. 

EUGENICS 

Alexander  Graham  Bell,  M.D.,  Board  of  Scientific  Directors,  Eugenics 
Record  Office. 

C.  B.  Davenport,  Director,  Carnegie  Station  for  Experimental  Evolution, 
Director,  Eugenics  Record  Office. 

Winfield  Scott  Hall,  M.D.,  Professor  of  Physiology,  Northwestern  Uni- 
versity Medical  School,  Chicago,  111. 

MENTAL  HYGIENE 

Lieut.-Col.  Thomas  W.  Salmon,  M.D.,  M.  C,  U.  S.  A.,  Medical  Director, 
National  Committee  for  Mental  Hygiene,  New  York. 

Elmer  E.  Southard,  M.D.,  Professor  of  Neuropathology,  Harvard  Medical 
School;  Pathologist  to  Massachusetts  State  Board  of  Insanity. 

ORGANIZED  PHILANTHROPY 

Mrs.  Elmer  Blair,  Chairman,  Public  Health  Department,  General  Federa- 
tion of  Women's  Clubs. 


[45  ] 


Lee  K.  Frankel,  %rd  Vice-President  and  Head  of  Welfare  Department,  Metro- 
politan Life  Insurance  Company. 

Thomas  N.  Hepburn,  M.D.,  Secretary,  Connecticut  Society  for  Social  Hygiene 

Wickliffe,  Rose,  Director,  International  Health  Commission. 

Wm.  Jay  Schieffelin,  Chairman  Executive  Committee,  Committee  of  One 
Hundred  on  National  Health. 

Maj.  Louis  Livingston  Seaman,  M.D.,  President,  The  China  Society. 

Lieut.-Col.  William  F.  Snow,  M.D.,  M.  C,  U.  S.  A.,  General  Secretary, 
The  American  Social  Hygiene  Association,  Inc. 

Lawrence  Veiller,  Secretary  and  Director,  National  Housing  Association. 

EDUCATIONAL 

W.  H.  Burnham,  Professor  of  Pedagogy  and  School  Hygiene,  Clark  University. 

W.  A.  Evans,  M.D.,  Professor  of  Sanitary  Science,  Northwestern  University 
Medical  School;  Health  Editor,  Chicago  Tribune. 

Norman  Hapgood,  Journalist. 

Maj.  Frederick  R.  Green,  M.D.,  M.  C,  U.  S.  A.,  Secretary,  Council  on 
Health  and  Public  Instruction,  American  Medical  Association. 

J.  N.  McCormack,  Chief  Sanitary  Inspector,  Board  of  Health,  State  of  Ken- 
tucky. 

M.  V.  O'Shea,  Professor  of  Education,  University  of  Wisconsin. 

Harvey  W.  Wiley,  M.D.,  Director,  Bureau  of  Foods,  Sanitation  and  Health, 
Good  Housekeeping  Magazine. 

INDUSTRIAL  HYGIENE 

John  B.  Andrews,  Secretary,  American  Association  for  Labor  Legislation. 

Maj.  Thomas  Darlington,  M.D.,  M.  C,  U.  S.  A.,  Secretary,  American 
Iron  and  Steel  Institute. 

George  M.  Kober,  M.D.,  Dean,  Medical  School,  Georgetown  University. 

Miss  Josephine  Goldmark,  Publication  Secretary,  National  Consumers' 
League. 

MOUTH  HYGIENE 

Alfred  C.  Fones,  D.D.S.,  Chairman  Dental  Committee,  Bridgeport  Board  of 
Health. 

George  H.  Wright,  D.D.S.,  Professor  of  Clinical  Dentistry,  Harvard  Medical 
School. 

PHYSICAL  TRAINING 
Wm.  G.  Anderson,  M.D.,  Director,  Gymnasium,  Yale  University. 


[46] 


George  J.  Fisher,  M.D  ,  Secretary,  International  Committee,  Y.  M.  C.  A. 

R.  Tait  McKenzie,  M.D.,  Professor  of  Physical  Education  and  Director  of  the 
Department,  University  of  Pennsylvania 

Dudley  A.  Sargent,  M.D.,  Director,  Gymnasium,  Harvard  University. 

Thomas  A.  Storey,  M.D.,  Professor  of  Hygiene,  College  of  the  City  of  New 
York.  Executive  Secretary,  Interdepartmental  Social  Hygiene  Board, 
Washington,  D.  C. 

FOREIGN  ADVISORY  BOARD 

CANADA 
Col.  John  George  Adami,  M.D.,  Professor  of  Pathology  and  Bacteriology 
McGill  University,  Montreal. 

CHILI 

Carlos  Fernandez  Pena,  M.D,,  President,  Association  of  National  Edu- 
cation; Secretary,  National  League  Against  Alcoholism. 

ENGLAND 

Sir  Thomas  Oliver,  Professor  of  Physiology,  Durham  University. 

FRANCE 

Armand  Gautier,  M.D.,  Professor  of  Chemistry,  Faculty  of  Medicine,  Paris. 

ITALY 

Leonardo  Bianchi,  Professor  of  Psychiatry,  University  of  Naples. 


JAPAN 

Prof.  Dr.  S.  Kitasato,  Chief  of  the  Kitasato  Institute  for  Infectious  Diseases, 
Tokyo. 

RUSSIA 

Ivan  Petrovic  Pavlov,  Professor  of  Physiology,  Military  Academy  of  Medi- 
cine, Petrograd. 


[47] 


The  Marchbanks  Press 
New  York 


RA427  L62 


Life  extension  institute,  inc. 


\ 


